Sunday, 10 April 2011

Don't Know What To Do.

So I've got a choice to make and I am not sure which way to go.

I have to choose which route in Social Work I am going to take; adults or children's?

When I first went in to Social Work I said there was no way that I was going to work with kids. I went in to it to do adult mental health and eventually do my AMHP training. However, while I still want to do my AMHP's training, after doing the law around children's I have found it a lot more interesting than I thought I would and I am starting to consider children's. I have never worked with kids in a social care setting. I don't have experience and I am expected to make a decision when I don't even know what it is like.What if I do my children's placement and decide, actually I do really like this, and it's too late?

I wanted to do adult mental health as of my own experiences in the system. It was a social worker who I had who was amazing back in 2007 that made me think about a career in the area. At the time I was doing a psychology degree and didn't really know where to take it. I was working in a bank as an account manager and I hated it. Working with him made me think, I could do this, I would enjoy this. I had thought about going down the psychology route but I was never going to have the money to do that. So I decided to get a job in a forensic female PD unit. I used that time to decide whether or not I wanted to go down the nursing route or social work. I did enjoy my job at first (I have written about it in a previous blog, and there is more I want to add about it which I will at the end of this), but I soon realised it was not the nurses who had a say in patient care, they just followed directions from the social workers and the rest of the MDT. I wanted to be one of the ones who had input in to patient care and one of the ones who can make decisions, not just follow someone Else's.

So yeah, I suppose I have a passion for adult mental health. Because of my own experiences and also because I know it already. I don't know other areas. It's the only area within adults that I could see myself doing. I don't really know what other areas there are and what you would do. Where as with children's I know of a few different areas and think I would find them all interesting. I don't want to risk choosing a pathway and not enjoying it as I am not doing what I want to be doing.

But then if I choose the children's route how likely is is I can work in adult mental health. It's a generic course that I am doing and choosing one doesn't mean I work in that for the rest of my life. I can change. But I know most people are offered a job off the back of their first placement. I don't want to put myself in a position where I am offered a job I don't want to take.

Also jobs; with all the cuts that are being made there is not that many jobs in adult services. I know more people choose the children's route and there are more jobs but I wonder if it's proportional?

I also wonder if it's possible to choose children's mental health and get my AMHP's that way. But there is even less of a need for children's mental health than adults.

I have been told by course director to follow my heart. My heart says adult mental health but my head says children's. I think there is a bigger possibility of finding work at the end of the course from children's but then do I want to be doing something that is not my interest. It's such a narrow area of adult's that I want to go in to also that there is no guarantee that I will be given a mental health placement for my 5 month placement. I really don't know which way to go. I keep weighing them up but they are about equal. So is it follow my head or follow my heart?

Going back to working in the forensic mental health unit.

Someone anonymously left a comment on that post basically saying by being a person who worked in a unit as such I was contravening human rights and I did provoke that patient in to attacking me. Well, they are wrong.

These patients (not inmates as the person put) had been sectioned under 3 or 37 and 37/41. These are people who would either be a big risk to other people in the community (they were in to things like arson, violent crimes etc) and they were massive risks to themselves. My self harm looks mild in comparison (and I am told mine will warrant hospitalisation if it carries on as it is severe). I won't say the things they did as it could trigger and give people ideas. Anyway, when someone was self harming themselves in a risky way (eg, ligating, cutting, biting chunks out of themselves etc) we would have no choice but to restrain if talking to them didn't work. Sometimes you didn't have the option but to restrain to go in and get what ever it was from around their necks or to stop them causing serious damage. None of the staff enjoyed restraining. It was a horrible experience but if you were going to get hit if you let go, you restrained. Why should be leave ourselves open to being hit by someone. No one deserves to go to work and expect to be attacked by patients. Yes, it is a risk, but it is something that should not happen.

Yes, sometimes people are not given privacy or others but even in the Human Rights Act 1998 can can clearly see that this can be contravened...
Article 8: Right to privacy

(1) Everyone has the right for his private and family life, his home and his correspondence.

(2) There shall be no interference by a public authority with the exercise of this right except such as is in accordance with the law and is necessary in a democratic society in the interests of national security, public safety or the economic well-being of the country, for the prevention of disorder or crime, for the protection of health or morals, or for the protection of the rights and freedoms of others.

So as you can see no human rights are taken away from them on that one. We are not living in the days of asylums now. Anything that is done to the patients, i.e restraint, or being IM'd etc is done so in accordance with the law and so that human rights are not contravened.

I take it you have experience as being a patient in a mental health setting and it seems as though your experience was not a good one and you are bitter about it. However, just because I have restrained someone so that they can't hurt themselves or another person does not count as provoking someone. In fact I don't think I had ever been involved in a full on restraint with this person.

She attacked me as she could not get what she wanted straight away. I was on high obs on someone else and it was because there were not enough staff on the ward. As awful as it sounds there were actually patients who made it so they were on high obs. When they were on high obs they had a member of staff with them at all times. They could get something from their room, they could be let in to laundry to go and check on their clothes. They didn't have to wait. So they would intentionally do something to land them on high obs. I was actually told this by one of the patients. She didn't feel it was fair that the people on high obs were able to get drinks etc when they wanted as they had staff with them. And she was right. Why should she have to wait when other people didn't. It was one of the things I brought up with my Charge Nurse about staffing before she shot me down about it.

So, that's my take on it.

Any advice on what to do in regards to pathways will be much appreciated....



Pandora said...

I have no personal experience of any type of social work, but most of my colleagues in my most recent job came from that background. My boss had spent most of her career in children's work and to be honest her accounts of it were pretty grim. She was insulted, swore at and even threatened on an almost daily basis, mainly by the kids' parents who saw her as an interfering do-gooder, but also by the children themselves at times. She'd have to go into all these horribly deprived areas where she was resented for her middle-class-ness. It's not a job I could do.

On the other hand, as noted, she did it for most of her career, so she can't have hated it! And as you have experience working with "difficult" clients (patients) already and were able to enjoy your work, there's no reason to assume you'd not enjoy it.

Think it over for as long as you can, but in the end you're probably best to go with whatever your gut instinct is :) Good luck whatever you decide to go for!

Take care

Pan x

Sheri said...

I agree with Pan. Go with your gut. It does sound like you're really leaning towards working with adults, though.

Marian said...

My take on your situation: help yourself, before you even think about wanting to help others. You have a lot of work ahead of you.